Thermographic characteristics of the diabetic foot with peripheral arterial disease using the angiosome concept

Abstract

Aim: To compare temperature changes following a challenge of limb elevation, in 3 forefoot angiosomes between type 2 diabetes mellitus patients with and without peripheral arterial disease (PAD).

Methods: Participans were categorized in a no PAD, mild PAD or severe PAD group. All underwent thermal imaging, then successive thermal images were taken at 1 min intervals after the lower limbs were elevated for 5 min. Thereafter, the lower limbs were lowered to the original position and imaged after 1 min. Mean temperatures of the hallux, medial and lateral forefoot were analysed by the angiosome concept.

Results: Forty-two limbs were analysed. Mean resting temperatures of all angiosomes of participants with PAD were higher than those with no peripheral arterial disease. A significant difference in the mean initial temperature between the groups was found in the medial and lateral forefoot angiosomes (p = 0.048, p = 0.049 respectively), whilst at the hallux these temperatures were not significant (p = 0.165). After limb elevation, the only significant difference was seen in the lateral foot area at 1 min (p = 0.021).

Conclusions: These results confirm that patients with PAD exhibit significantly higher forefoot temperatures, according to the angiosome concept. The challenge by foot elevation did not affect the thermal pattern significantly.